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Marasmus …. in Ireland

During a recent research project, I was shocked to come across an Irish death certificate for a baby girl named Martha aged just under 15 months upon which the Certified Cause of Death was declared by a physician to be “Marasmus.” This is the condition which often claims the lives of very under-nourished infants living in areas of severe famine. We have all seen the haunting images of terrified black children with bloated tummies and heads attached to skeletal frames filmed during recent famines in war-torn African countries. The medical term for the distorted human condition you were witnessing is marasmus.

However, my Irish death cert of concern was not from the Great Famine era of Ireland, namely the late 1840’s. Civil death registration in Ireland did not commence until 1864. This particular death certificate, shown below, dated from 1877 when Ireland had overcome the worst of the economic depression in the post-Famine years. So how could a one year-old baby just starve to death in a West of Ireland family home at this time? This was a scenario which troubled me, especially when my research revealed that baby Martha had six older siblings who all appeared to survive childhood with relative and commendable ease.

The death of Martha occurred on 28th February 1877 in the County Galway village of Kilchreest. The baby’s parents were Patrick & Margaret. On first viewing the certificate I noted that Margaret reported the death, and this was a common but tragic duty for the mothers of infants who died very young, but usually as a result of fever or generally sub-standard living conditions. MARASMUS though! This diagnosis bothered me.

It was not until my client commissioned me to investigate more fully the background of her Irish ancestors that I discovered the whole sorry tale of poor Martha’s last few weeks on earth. The story was more tragic than I could have imagined.

In being asked to compile complete Family Trees, it was one of my tasks to find out when Martha’s parents died. All of her surviving older siblings emigrated to America, but Martha’s parents never crossed the Atlantic Ocean to join them, and they were also absent from the 1901 Irish census. Logically, both of Martha’s parents must have died before April 1901 and after youngest child Martha’s conception in 1875. I eventually found a matching death record for Martha’s father, Patrick; he died in the year 1900 as a widower. For days after, I struggled to locate any reference at all to the demise of Martha’s mother, Margaret. She was dead by 1900, and she reported baby Martha’s death in February 1877, yet there was no matching death record in the intervening years in County Galway, or the whole of Ireland, or anywhere in the civilized world for that matter. I was stumped – until I made an accidental discovery.

For some reason I cannot recall, I carried out my search for Margaret’s death record one more time. On this occasion, I must have left the span of years for my database search engine to interrogate as Martha’s DOB (in 1875) up until 1900. Up popped mother Margaret’s death registration …. in November 1876 …. so mother Margaret had died three months before her baby Martha. Ugh? So who was the female with the same name as Martha’s mother who registered the baby’s death. It took a while before the truth dawned on me.

Earlier research had determined that Martha’s father, Patrick, was most likely an illegitimate child. Patrick could not name his father when he married Margaret, in spite of the fact that this was a normal legal obligation prior to a marriage being recognized by the British state. So Patrick had no family network to step in when his wife tragically died and left him with seven children to raise single-handedly. Patrick worked on a country estate looking after the land and domestic animals on behalf of wealthy employers, and I reckon that he felt forced to carry on with his work in order to keep his family fed, after Feb 1877. Then it HIT me! Patrick’s eldest daughter was Margaret, born in 1864. This girl was aged just 12 years when her mother died …. and 12 year-old Margaret then became the surrogate mother for her six tiny siblings. Somehow, she managed to keep them all alive as her father Patrick spent long hours away from the family’s cottage in Kilchreest village …. but baby Martha needed a proper biological mother.

12 year-old Margaret toiled as best she could, but eventually Martha could not retain nourishment. After three months in Margaret’s care, baby Martha gave up the will to live as an underfed deformed human soul, in front of Margaret’s eyes, and probably in front of a traumatized group of young siblings. Martha’s death certificate confirms that “Margaret” was “Present at Death.”

Having absorbed these facts, it then became apparent that little Margaret suffered the final indignity of having to formally report the death of her baby sister to the local Registrar. Technically, Margaret was under the legal age to carry out such a sad task – and where was her father Patrick when this matter was reported on 14th March 1877? In fact, where was any neighbourhood support in these days before Social Workers stepped in to ease the burden on dysfunctional families? Shame on them all.

Perhaps the worst castigation should be spared for the family’s local physician. This man calmly advised the Registrar that poor Martha’s condition of Marasmus had been certified for eight weeks prior to death! In other words, this so-called doctor was aware of Martha’s drastic under-nourishment by early January 1877 at the latest, yet he left a dying baby in the care of her 12 year-old sister …. and just walked away from the evolving tragedy.

The only good news is that Martha’s siblings all escaped the Irish poverty trap and all eventually settled in various parts of America. Amazingly, one of Martha’s sisters lived to the grand old age of 103 years and retained a computer-like memory right up until her dying day. When this day came in 1972, she could still recount the story of her baby sister who died back in the Galway cottage homestead …. where no-one seemed to care about fatal circumstances which scarred young minds forever.

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3 thoughts on “Marasmus …. in Ireland”

I have just discovered this diagnosis on the death certificate of a baby who died in Athlone in 1949 – again, the mother was present at the death. The baby was diagnosed at 1 month with Marasmus and died at 1 3/4 months of Congenital Heart Disease. The birth & death were never discussed in the family and there is no-one left now to ask how this could have happened. After looking on-line it seems that CHD can cause failure to thrive and most babies with this condition (in the UK) died within the first year of life. The marasmus would not have been caused by poverty so I’m assuming it must have been the CHD and lack of adequate medical care for newborns in rural Ireland at that time. I can only imagine the horror the mother must have suffered, literally watching her new baby starve to death despite all her desperate efforts. So sad.

Jenna – did your 1949 baby of interest die at a family home, or at a “mother & baby” home? A recently publicised report has highlighted the scandalous number of illegitimate Irish babies who perished in convent-type “care homes” circa 1950. Some of these institutions allowed the mother to nurse their children for a few years (a la Philomena, the movie). Shockingly, the cause of death of numerous babies in the report was marasmus. Maybe CHD is the common link – but could so many babies have suffered gross malnutrition until marasmus took its fatal hold?

Gearoid – the baby was born at St Vincent’s Hospital in Athlone and died at the Stella Maris Home (also in Athlone) 6 weeks later. I don’t know if this was a “mother & baby” home or not but the parents were married and living together in Athlone at the time – and the father was employed – so the baby was born legitimately (albeit only just). They had married in the April, the baby was born in August and died in September. I know that it wouldn’t have been poverty in this particular case so I can only assume that the baby’s failure to thrive was caused by the congenital heart disease and lack of adequate medical care or knowledge. Perhaps the Stella Maris Home was, indeed, a mother & baby home and, because of that, the local doctors would refer paediatric cases there instead of the general hospital?